Aetna Says 'Embedded' Case Managers Lowering Costs, Improving Care

Aetna Inc. said Thursday it has been successful in improving care and reducing medical costs for more than 50,000 of its Medicare Advantage customers.

The health insurer has put "embedded" nursing case managers in about 70 doctor offices and clinics across the U.S. that serve Aetna's Medicare Advantage patients. The program has been around for six years. Its success was part of a broader effort by Aetna to implement "accountable care" plans, which provide incentives to medical providers to hold down costs while ensuring better care of patients.

The program of embedded registered nurses includes about 6,000 Medicare Advantage members in Connecticut served by one of four participating doctor groups or hospitals.

In one such program with NovaHealth, a doctor group in Portland, Maine, Aetna found that patients in the program had 50 percent fewer inpatient days in a hospital, 45 percent fewer hospital admissions and 56 percent fewer readmissions than other Medicare recipients in that state.